Provider Demographics
NPI:1730212952
Name:NGUYEN, HANH NGOC (DDS)
Entity type:Individual
Prefix:
First Name:HANH
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2222
Mailing Address - Country:US
Mailing Address - Phone:661-725-9430
Mailing Address - Fax:661-725-7221
Practice Address - Street 1:1406 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2222
Practice Address - Country:US
Practice Address - Phone:661-725-9430
Practice Address - Fax:661-725-7221
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD53721011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD5372101Medicaid